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蛛网膜下腔出血后严重脑血管痉挛时颈静脉血氧饱和度的监测

[Monitoring jugular venous oxygen saturation in severe cerebral vasospasm after subarachnoid hemorrhage].

作者信息

Stordeur J M, Bruder N, Cantais E, Pellissier D, Levrier O, Gouin F

机构信息

Département d'anesthésie réanimation, CHU Timone, Marseille, France.

出版信息

Ann Fr Anesth Reanim. 2000 Feb;19(2):111-4. doi: 10.1016/s0750-7658(00)00111-8.

Abstract

Cerebral arterial vasospasm is a major complication of aneurysmal subarachnoid haemorrhage. The conventional treatment of this complication includes haemodilution, hypervolaemia, arterial hypertension and nimodipine. Some patients do not respond to this therapy and require an intraarterial infusion of papaverine and/or a cerebral angioplasty. Transcranial Doppler detects cerebral vasospasm. However it does not provide an accurate metabolic information on the ischaemic status of the cerebral tissue. This article describes the monitoring of jugular venous bulb oxygen saturation to obtain a real time information on the metabolic effect of cerebral vasospasm and its variations after intra-arterial infusion of papaverine.

摘要

脑动脉血管痉挛是动脉瘤性蛛网膜下腔出血的主要并发症。该并发症的传统治疗方法包括血液稀释、血容量增多、动脉高血压以及使用尼莫地平。一些患者对这种治疗无反应,需要动脉内输注罂粟碱和/或进行脑血管成形术。经颅多普勒可检测到脑血管痉挛。然而,它无法提供关于脑组织缺血状态的准确代谢信息。本文描述了通过监测颈静脉球血氧饱和度来获取关于脑血管痉挛代谢效应及其在动脉内输注罂粟碱后变化的实时信息。

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